Yep, I started my group myself and did one exit in Jan 2019 and another planned this summer. All these deals are NOT created equal. In many/most instances where the founder doc stays engaged and actually spends money on proper representation, on an exit, things are totally fine and patients are thankful their docs are generally in a better mood due to a better lifestyle / better pay. One huge caveat, we're the platform company meaning when we buy you're under me/us. If you are not you have little to no power when you sell.
But the billing out of network etc is zero issue with us and nobody has ever told me/us how to practice. But just like anything else if you give the banks too much power they'll run anything over for the good ole dollar. Also, the platform company is 100% owned by the friendly physician. We're in 45 states and have 1500 doctors. If they really wanted to push me there's several states I could just say fuck off and take over the operation on my own - again, it won't happen because we have a great relationship but I'm here to tell you, many times those PE firms are acting like that because a shady/soft doctor is letting it happen. There's my 2 cents, flame away.